Desirability Scores Research Articles

The influence of living environments on subjective health literacy in fourth-graders in Germany

Abstract Background Evidence suggests that worse family affluence is related to low health literacy in children. Still, for the targeted promotion of health literacy, a more nuanced understanding is needed of how living environments affect health literacy in early life. This study explores the relationships between health literacy and indicators of living environments in the neighborhood and at home. Methods A representative sample of 4th-graders (age 8-11) was surveyed from Oct. 2022 to Feb. 2023 in North Rhine-Westphalia, Germany. We included the HLS-Child-Q15 to assess subjective health literacy, 4 items about the neighborhood (e.g., “neighborhood is a good place to play outside” or “I often see people smoking in the neighborhood”), and 4 items about home (e.g., “there’s always fruit and vegetables at home” or “it’s important to my parents that I exercise”). The tendency to answer in a socially desirable way was controlled for with a validated scale. Likert-scale items were dichotomized for use in linear regression. Results n = 1085 students are included, 50.3% are female. The mean age is 9.5 years (SD=.6). The regression model explains 17.8% of variability in health literacy (corr. R²). Significant (p<.05) predictors for high health literacy were birthplace (Germany, not Germany), agreement to the statements “I often see people exercising in my neighborhood”, “my parents can answer all my question about health”, “there’s always fruit and vegetables at home”, “it’s important to my parents that I exercise”, but also social desirability scores. Family affluence was not a significant predictor. Conclusions In this sample of 4th-graders, subjective health literacy could not adequately be explained by family affluence. Indicators of living environments seem to be better suited to explore variability in health literacy. These findings can be used to explore entry points for the promotion of health literacy early in life and to identify groups at risk for low health literacy.

The impact of the COVID-19 pandemic on university students

Introduction/Objective. Our study aims to investigate the effects of COVID-19 pandemic on dyspnea, exercise capacity and mood in university students. Method. A total of 120 university students were included in this prospective study. The students' scores of desire to exercise, hopelessness (Beck Hopelessness Scale), fatigue severity (Fatigue Severity Scale), shortness of breath (Modified Medical Research Council (mMRC) Dyspnea Scale), and pain (Visual Analogue Scale) before and after the onset of the SARS-CoV-2 pandemic were determined using scales, face-to-face and online surveys. The Shapiro-Wilk, Mann-Whitney U, Wilcoxon Signed Rank test and the chi-square tests were used. In the data analysis, a p-value of less than .05 was considered statistically significant. Results. A total of 120 subjects were included in the study, 95 of whom (79.2%) identified as female. The mean age of the participants was 22.8±5.3 (18-45) years. It was observed that the scores for hopelessness, shortness of breath, pain, and fatigue in the group with a history of SARS-CoV-2 infection increased significantly (p<0.05) compared to the pre-pandemic period. Conversely, the desire to exercise exhibited a notable decline (p<0.05). Conclusion. In university students, increased hopelessness, fatigue, shortness of breath and decreased desire to exercise after the COVID-19 pandemic may have developed secondary to post-COVID syndrome and immobility due to lockdown.

Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons.

Laparoscopy training remains inaccessible in many low- and middle-income countries, including Liberia. We assessed the availability of laparoscopy and feasibility of implementing a laparoscopic program among Liberian surgeons and trainees. This mixed-methods study utilized a 32-item survey and semi-structured interviews on laparoscopic experience, knowledge, desires, barriers, patient perceptions, and training opportunities among surgeons and trainees at Liberia's two main teaching hospitals in March 2023. Data analysis utilized summed knowledge and desirability scores, descriptive statistics, and qualitative content analysis. 31 interns, residents, and consultants participated, comprising 60% of Liberia's surgeons. Laparoscopic training (32%) and experience (16%) was low, with exposure limited to those training outside Liberia (p=0.001). While laparoscopy knowledge varied (29% low, 55% medium, 16% high), participants expressed high interest in training (100%) and willingness to pay (52%). Interviews revealed four themes: desires for training, patient acceptability, feasibility of technology-based training, and barriers including limited equipment and expert trainers. At the time of survey, the only minimally invasive surgeries ever performed in Liberia were two diagnostic laparoscopies. This is the first mixed-methods study assessing laparoscopy in Liberia. Our sample, though small, comprised approximately 60% of Liberian surgeons in both rural and urban hospitals. Findings demonstrated limited experience, variable knowledge, and high desires for training, showing feasibility for laparoscopy implementation in Liberia.

Numerical investigation of the geometric parameters effect of helical blades installed on horizontal geo heat exchanger

In this study, we investigate the enhancement of horizontal geothermal heat exchangers equipped with helical fins on the pipe's exterior and internally ribbed turbulators. Our approach focuses on the interplay between geometry and thermal efficiency through innovative design modifications. Utilizing the finite element method, three-dimensional numerical simulations assessed the effects of varying geometric parameters such as the diameter and thickness of the fins. Our findings indicate significant increases in heat transfer efficiency with the addition of helical fins; specifically, increasing the fin diameter from 5 mm to 10 mm results in a 15 % increase in the heat transfer rate, while doubling the fin thickness from 2 mm to 4 mm enhances the rate by 10 %. These improvements are due to the expanded surface area facilitating greater heat exchange. Optimization using the desirability function approach yielded models with high performance, achieving desirability scores of 0.9879 for outlet temperature and 0.9534 for the heat transfer coefficient. This reflects the effective tuning of geometric parameters to maximize thermal performance. The study also introduces two predictive mathematical models for the outlet temperature and convective heat transfer coefficient of the U-shaped pipe equipped with these enhancements. These models, derived from extensive numerical data, provide practical tools for future design and operational applications of geothermal heat exchangers. This research advances the design and operational efficiency of geothermal heat exchange systems, establishing new benchmarks for thermal efficiency in the field with actionable insights and robust mathematical tools.

Investigating the relationship between spermogram parameters and sexual desire in infertile men: a cross-sectional study from a tertiary centre in Iran

BackgroundMale factor infertility can affect spermatogenesis, sexual desire, and thus the quality of life of couples. The present study was conducted to investigate the relationship between spermogram parameters, and the...

Prioritizing industrial wastes and technologies for bioenergy production: Case study

Energy supply stability in the industrial sector is crucial to maintain operational efficiency and avoiding costly disruptions. In the face of pressing environmental challenges, transitioning to sustainable, efficient, and eco-friendly energy sources is imperative. This study aims to assess the potential of industrial waste for bioenergy production in Khorasan Province, Iran, addressing the research gap of developing a comprehensive framework of criteria that was lacking in previous studies. Employing a combined technology and material assessment methodology, the research began with the collection and analysis of questionnaires to identify and weight critical criteria using Shannon Entropy and expert insights. The Additive Ratio Assessment method was then used to rank various types of industrial waste and technologies according to established value criteria. The Findings reveal that anaerobic digestion of organic waste emerges as the most viable bioenergy solution with an 85 % desirability score, followed by anaerobic digestion of sewage sludge and gasification of plastic waste, scoring 77.31 % and 69.41 %, respectively. The innovative aspect of this study is the development and implementation of five novel evaluation criteria, including process temperature, technology lifetime, production cost, waste collection cost, and waste separation cost, which have not been previously applied to the assessment of industrial waste for renewable energy production, especially in developing countries.

Liver transplantation improves erectile function in patients with end-stage liver disease: a systematic review and meta-analysis.

Liver transplantation (LT) has been recognized as the most effective therapy for end-stage liver disease (ESLD). However, the question of whether LT can improve erectile function in patients with ESLD remains controversial. Therefore, we conducted this meta-analysis to evaluate the association between LT and erectile dysfunction (ED). According to the PRISMA guidelines, studies were included after conducting searches in four databases from March 2024 onwards. These databases included PubMed, Cochrane Library, Web of Science, and Embase. The primary outcome of interest was to compare the International Index of Erectile Function (IIEF) scores between patients after and before LT. Standardized mean differences (SMDs) and their corresponding 95% confidence intervals (CIs) were utilized to assess the relationship between LT and ED. The results showed that the LT group had higher IIEF-5 domain scores for erectile function compared to the control group (SMD =-0.31, 95% CI: -0.53 to -0.09), P=0.007). No heterogeneity or publication bias was detected in the results. Additionally, the IIEF-15 domain score was also found to be improved after LT. Specifically, the LT group had higher domain scores for erectile function (SMD =-0.77, 95% CI: -1.07 to -0.48, P<0.001), orgasmic function (SMD =-0.82, 95% CI: -1.12 to -0.52, P<0.001), sexual desire (SMD =-0.89, 95% CI: -1.19 to -0.59, P<0.001), intercourse satisfaction (SMD =-0.92, 95% CI: -1.22 to -0.62, P<0.001), and overall satisfaction (SMD =-0.87, 95% CI: -1.17 to -0.57, P<0.001). It is suggested by our meta-analysis that LT may contribute to improvements in erectile function among men with ESLD. This improvement may be related to the remarkable improvement in endocrine hormone disorders observed after LT. However, future studies with better designs and larger sample sizes are still needed to confirm our conclusions. Additionally, attention to erectile function before and after surgery in patients with liver failure is crucial.

Effects of obsessive beliefs and anxiety on sexual function in HPV-positive men.

Our study aimed to investigate the effects of anxiety and obsessive beliefs on sexual function in men with human papillomavirus (HPV) and healthy men. Ninety HPV-positive men (mean age=32.26 ± 6.63 years) from the Urology Outpatient Clinic and 75 healthy men (mean age=33.51 ± 5.67 years) who worked in the hospital were assessed using the International Index of Erectile Function-15 (IIEF-15), Obsessive Beliefs Questionnaire-44 (OBQ), and State-Trait Anxiety Inventory (STAI) in 2023. The mean IIEF-15 scores of the patients with HPV and healthy individuals were 24.59 ± 6.14 vs. 23.16 ± 6.23 for the IIEF-erectile function; 8.30 ± 2.34 vs. 7.79 ± 1.77 for the IIEF-orgasmic function; 7.40 ± 1.73 vs. 7.23 ± 1.53 for the IIEF-sexual desire; 11.30 ± 3.38 vs. 11 ± 3.10 for the IIEF-intercourse satisfaction; and 7.62 ± 2.18 vs. 7.53 ± 2.02 for the IIEF-overall satisfaction (p > 0.05 for all). However, the mean OBQ and STAI scores of patients with HPV and healthy individuals were 46.66 ± 16.06 vs. 36.44 ± 19.25 for the OBQ-inflated responsibility/overestimation of threat (OBQ-RT); 45.91 ± 17.31 vs. 36.53 ± 19.08 for the OBQ-perfectionism/intolerance of uncertainty (OBQ-PU); 28.04 ± 12.31 vs. 23.80 ± 11.74 for the OBQ-importance of thought/control thoughts (OBQ-IC); 37.58 ± 12.06 vs. 33.59 ± 11.09 for the STAI-state anxiety (p < 0.05 for all); and 32.83 ± 8.34 vs. 33.44 ± 11.05 for the STAI-trait anxiety (p = 0.689). Our results showed that the STAI-state anxiety (β = -0.37; β = -0.32; and β = -0.43, respectively) and OBQ-IC (β = -0.57; β = -0.43; and β = -0.48, respectively) scores were the main predictors of the IIEF-erectile function, IIEF-orgasmic function, and IIEF-overall satisfaction scores in the HPV-positive group. The OBQ-RT (β = 0.46), OBQ-PU (β = -0.51) and STAI-state anxiety (β = -0.56) scores were unique predictors of the IIEF-sexual desire score, and the OBQ-RT (β = 0.41), OBQ-PU (β = -0.42), and OBQ-IC (β = -0.43) scores were the main predictors of the IIEF-intercourse satisfaction score in the HPV-positive group. However, regression models for the IIEF-15 subscales for the control group were not significant (p ˃ 0.05). Understanding the role of obsessive beliefs and anxiety in sexual dysfunction among HPV-positive men might be important for developing psychotherapeutic interventions.

Impact of Telemedicine on Women's Sexual Dysfunction: A Systematic Review and Meta-Analysis

Context: Sexual satisfaction is crucial for women's overall well-being; however, traditional interventions often face challenges such as high costs, limited access, inadequate specialized care, and discomfort during counseling sessions. Telemedicine presents a promising solution to these issues. Objectives: This systematic review and meta-analysis evaluate the efficacy of telemedicine interventions in improving sexual function and satisfaction among women. Evidence Acquisition: We searched SCOPUS, Web of Science, and PubMed for relevant articles published up to January 2024. The search strategy and keywords were crafted using the PICO approach to align with the study's objectives and ensure a comprehensive and structured review. The quality of the included studies was assessed using the Jadad scale. The primary outcome measures were sexual desire, arousal, lubrication, orgasm, pain, satisfaction, and overall Female Sexual Function Index (FSFI) scores. A random-effects model was employed for the meta-analysis, and the I-square index was used to assess heterogeneity. Results: The systematic review identified six studies from an initial pool of 4,174 that demonstrated a positive effect of telemedicine interventions on all domains of the FSFI questionnaire, except for the pain domain and overall sexual function scores in women. The effects of telemedicine on sexual desire [standardized mean difference (SMD) = 0.92, 95% CI = 0.51, 1.32], sexual arousal (SMD = 0.97, 95% CI = 0.42, 1.53), vaginal lubrication (SMD = 0.41, 95% CI = 0.23, 0.59), orgasm (SMD = 0.40, 95% CI = 0.21, 0.58), sexual satisfaction (SMD = 0.74, 95% CI = 0.48, 1), and total FSFI (SMD = 1.03, 95% CI = 0.49, 1.58) were found to be significant. However, the effect on pain was not statistically significant (SMD = 0.15, 95% CI = -0.10, 0.40). Conclusions: This study supports the effectiveness of telemedicine in improving women's sexual satisfaction and function. However, due to limitations in the included studies, such as small sample sizes, lack of randomization, and lack of blinding in some cases, more comprehensive studies are recommended. Future research should address these methodological limitations to provide stronger evidence on the effectiveness of telemedicine interventions for women's sexual health.

Effectiveness of multimedia education on the childbearing intention in one-child women: a field trial study

Backgroundchildbearing is a key component of population movements and sustainable development in low-fertility nations. This study was conducted with the aim of determining the impact of multimedia education on the childbearing intention in One-child women of Maragheh city.MethodIn this intervention study in Maragheh in 2023, 94 women with one child were randomly selected and placed in two intervention and control groups. Before the intervention, people were examined using demographic information and Miller’s questionnaire of desire to have children. Then, For the intervention group, three 60-minute multimedia training videos were shown in person for three weeks, and the control group did not receive any training. The data were collected using the researcher’s demographic questionnaire and Miller’s childbearing questionnaire in three stages before the intervention, immediately after and six weeks after the intervention. Data analysis was done with SPSS version 16 software.ResultsThere was no significant difference between the two groups in terms of the average score of desire to have children and demographic variables (p > 0.05). Before the intervention, there was no significant difference between the intervention and control groups in terms of the demographic characteristics of the subjects and the average score of women’s willingness to have children in the positive and negative dimensions. While after the multimedia educational intervention, the average score of desire to have children in positive and negative dimensions, immediately after the intervention and six weeks after the intervention, had a significant difference compared to before the intervention (p < 0.001).ConclusionThe findings of the study showed that carrying out multimedia educational interventions to single-child women can have a positive effect on their desire to have children. It seems that the implementation of such programs is effective in the conscious decision of families to have children and ultimately increases the intention of the individual to carry out the behavior.Trial registrationIranian Registry of Clinical Trials: IRCT20230227057549N1. Date of registration: 16/04/2023. URL: https://irct.behdasht.gov.ir/.

Precision Enhancement in Tough Polylactic Acid Material Extrusion: A Systematic Response Surface Investigation for Sustainable Manufacturing

&lt;div&gt;This research systematically explores the significant impact of geometrical dimensions within fused deposition modeling (FDM), with a focus on the influence of raster angle and interior fill percentage. Through meticulous experimentation and the application of response surface modeling (RSM), the influence on critical parameters such as weight, length, width at ends, width at neck, thickness, maximum load, and elongation at tensile strength is thoroughly analyzed. The study, supported by ANOVA, highlights the notable effects of raster angle and interior fill percentage, particularly on width at ends, width at neck, and thickness. During the optimization phase, specific parameters—precisely, a raster angle of 31.68 and an interior fill percentage of 27.15—are identified, resulting in an exceptional desirability score of 0.504. These insights, substantiated by robust statistical data, fill a critical gap in the understanding of 3D-printed parts, offering practical recommendations for superior mechanical performance across diverse applications.&lt;/div&gt;

FORMULATION AND IN VITRO CHARACTERIZATION OF METOCLOPRAMIDE LOZENGES BY USING THE QUALITY BY DESIGN (QBD) APPROACH

Objective: Conventional dosage forms may not be suitable for all patients, especially those facing difficulty with swallowing, which results in reduced adherence to medication, impacting treatment outcomes. This study aimed to formulate and characterize metoclopramide lozenges using the quality-by-design approach to provide a patient-friendly alternative. Materials and Method: Formulations were optimized using response surface methodology and a Design Expert, focusing on Metoclopramide, Citric Acid, and Carboxymethyl Cellulose, with hardness and dissolution as primary response variables. The experimental design involved 20 runs, six replications of the central point, and a quadratic model for improved model fitting, with adjustments made through transformation and numerical hill-climbing algorithms. Results and Discussion: Formulations of metoclopramide lozenges were obtained through a systematic quality-by-design approach. Using numerical optimization, the formulation with the highest desirability score of 1.00 was selected, yielding a hardness of 14.55 kg and a dissolution time of 1.25 minutes. The optimal coded values were 1.53223 grams for Metoclopramide (A), 4.84302 grams for Citric acid (B), and 18.5048 grams for Carboxymethyl cellulose (C). The optimized formulation was subjected to in vitro testing to validate its performance, yielding a hardness ranging from 13.98 to 15.00 kg/cm2 and a dissolution time ranging from 1.11 to 2.23 minutes. The effectiveness of the QbD approach was confirmed as outcomes closely aligned with the targeted responses. Conclusions: The Quality by Design approach was found effective in optimizing the formulation of metoclopramide lozenges. Using the Design of Expert and Response Surface Methodology, an optimized formulation was obtained with the desired hardness and dissolution rate. Peer Review History: Received 26 April 2024; Revised 4 May 2024; Accepted 28 June; Available online 15 July 2024 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, toyinpharm@gmail.com Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. Hatem Sameir Abbas, Al-Azhar University, Egypt, hsam8406@yahoo.com

Exploring the Intersection of Depression, Anxiety, and Sexual Health in Perimenopausal Women.

The perimenopausal period is marked by hormonal fluctuations that trigger a complex interplay between estrogen levels and neurotransmitters' function, contributing to increased susceptibility to depression and anxiety in women. Concurrently, hormonal changes, coupled with alterations in vaginal tissue, lead to sexual dysfunction during this transitional phase. This study aimed at evaluating the association between menopausal symptoms and sexual dysfunction among perimenopausal women and identifying the mediating effects of depression and anxiety on this association. Data for the present cross-sectional study were collected from participants via Arabic versions of three questionnaires; the modified Menopausal Rating Scale (MRS), the Female Sexual Functioning Index (FSFI) and the Hospital Anxiety and Depression scale (HADS). Our study was conducted on 149 females with age ranged from 45 to 55 years. On studying the relation between modified MRS and HADS, the menopausal symptoms were significantly high among female with high anxiety scores. Regarding the relationship between MRS and FSFI, women with anxiety and physical and mental exhaustion had significantly lower FSFI scores than women without such symptoms (19.2 [2-31.4] vs 21.7 [3.8-30.9], p = 0.04, respectively). Furthermore, there were statistically significant negative correlations between depression scores and sexual desire (r = -0.32, p < 0.001), arousal (r = -0.25, p = 0.003), and total FSFI scores (r = -0.27, p = 0.04). Perimenopausal women experience a confluence of challenges related to depression, anxiety, and sexual dysfunction. Understanding the interconnectedness of hormonal and psychosocial factors is essential for tailored interventions aimed at improving mental health and sexual well-being during this transitional phase.

Willingness to Provide Naloxone Resources for Patients at Risk of Opioid Overdose: A National Survey of Emergency Registered Nurses

IntroductionOpioid-related events continue to claim lives in the United States at alarming rates. Naloxone-dispensing rates fall dramatically short of national expectations. Emergency registered nurses are uniquely poised to connect at-risk patients with naloxone resources. This study sought to (1) describe the emergency registered nurses’ willingness to provide naloxone resources and (2) explore variables that may influence the nurse’s willingness to provide resources. MethodsA cross-sectional, survey-based design was deployed using an online branch logic approach to include a national sample of emergency registered nurses. The Willingness to Provide, a validated questionnaire, measured the registered nurse’s willingness to provide naloxone resources for patients at risk of opioid overdose. Eight variables were assessed for potential influence on willingness. ResultsA total of 159 nurses from 32 states and the District of Columbia completed the online survey via the Research Electronic Data Capture platform. The results revealed a mean Willingness to Provide score of 38.64 indicating a willingness to provide naloxone resources. A statistically significant relationship was identified between the nurse’s willingness and years of nursing experience (P = .001), knowledge (P = .015), desire (P = .001), and responsibility (P < .001). DiscussionIn this representative sample, emergency nurses are willing to provide naloxone resources; furthermore, results indicate that higher knowledge, desire, and responsibility scores increase the nurse’s willingness to provide naloxone resources; with education and clear expectations, emergency nurses may be able to improve the connection of patients at risk of opioid overdose with naloxone, a potentially lifesaving connection.

Role of flibanserin in managing hypoactive sexual desire disorder in women: A systematic review and meta-analysis.

Flibanserin, approved for the treatment of hypoactive sexual desire disorder (HSDD) in females, has demonstrated diverse therapeutic and adverse effect (AE) prospects in the extant randomized controlled trials (RCTs). This meta-analysis aimed to characterize the outcomes of flibanserin use in these patients comprehensively. RCTs involving women with HSDD receiving flibanserin in the intervention arm and placebo in the control arm were sought after throughout the electronic databases. The primary outcomes were the changes from baseline in satisfying sexual events (SSE) per month and sexual desire score per month measured using an electronic diary (eDiary). From 478 initially screened articles, data from 8 RCTs involving 7906 women with HSDD were analyzed. In premenopausal women, flibanserin 100 mg was superior to placebo in improving the number of SSE per month (mean difference, MD 0.69, 95% CI [0.39, 0.99]), eDiary sexual desire score (MD 1.71, 95% CI [0.43, 2.98]), Female Sexual Function Index (FSFI) desire domain (FSFI-d) score (MD 0.30, 95% CI [0.29, 0.31]), FSFI total score (MD 2.51, 95% CI [1.47, 3.55]), Female Sexual Distress Scale-Revised (FSDS-R) Item 13 score (MD -0.30, 95% CI [-0.31, -0.29]), and FSDS-R total score (MD -3.30, 95% CI [-3.37, -3.23]). Compared to placebo, a higher number of premenopausal women using flibanserin 100 mg achieved improvements in the Patient's Global Impression of Improvement score (OR 1.93, 95% CI [1.58, 2.36], P < .00001) and responded positively at Patient Benefit Evaluation (PBE) (odds ratio, OR 1.76, 95% CI [1.34, 2.31], P < .0001). Postmenopausal women receiving flibanserin 100 mg also benefited in terms of the number of SSE per month, FSFI-d and total scores, FSDS-R Item 13 and total scores, and PBE response. Although flibanserin use was associated with higher risks of dizziness, fatigue, nausea, somnolence, and insomnia, these adverse events were mild in nature; the serious AEs and severe AEs were comparable between the flibanserin and placebo groups. While flibanserin has demonstrated efficacy in the treatment of HSDD in both pre- and postmenopausal women, its therapeutic advantages may be overshadowed by the higher likelihood of AEs.

Preliminary Efficacy of Topical Sildenafil Cream for the Treatment of Female Sexual Arousal Disorder: A Randomized Controlled Trial.

To assess the efficacy of topical sildenafil cream, 3.6% among healthy premenopausal women with female sexual arousal disorder. We conducted a phase 2b, exploratory, randomized, placebo-controlled, double-blind study of sildenafil cream. Coprimary efficacy endpoints were the change from baseline to week 12 in the Arousal Sensation domain of the SFQ28 (Sexual Function Questionnaire) and question 14 of the FSDS-DAO (Female Sexual Distress Scale-Desire, Arousal, Orgasm). Two hundred women with female sexual arousal disorder were randomized to sildenafil cream (n=101) or placebo cream (n=99). A total of 174 participants completed the study (sildenafil 90, placebo 84). Among the intention-to-treat (ITT) population, which included women with only female sexual arousal disorder and those with female sexual arousal disorder with concomitant sexual dysfunction diagnoses or genital pain, although the sildenafil cream group demonstrated greater improvement in the SFQ28 Arousal Sensation domain scores, there were no statistically significant differences between sildenafil and placebo cream users in the coprimary and secondary efficacy endpoints. An exploratory post hoc subset of the ITT population with an enrollment diagnosis of female sexual arousal disorder with or without concomitant decreased desire randomized to sildenafil cream reported significant increases in their SFQ28 Arousal Sensation domain score (least squares mean 2.03 [SE 0.62]) compared with placebo cream (least squares mean 0.08 [SE 0.71], P =.04). This subset achieved a larger mean improvement in the SFQ28 Desire and Orgasm domain scores. This subset population also had significantly reduced sexual distress and interpersonal difficulties with sildenafil cream use as measured by FSDS-DAO questions 3, 5, and 10 (all P ≤.04). Topical sildenafil cream improved outcomes among women with female sexual arousal disorder, most significantly in those who did not have concomitant orgasmic dysfunction. In particular, in an exploratory analysis of a subset of women with female sexual arousal disorder with or without concomitant decreased desire, topical sildenafil cream increased sexual arousal sensation, desire, and orgasm and reduced sexual distress. ClinicalTrials.gov , NCT04948151.

(121) DISCREPANCY IN SEXUAL DYSFUNCTION, SEXUAL DESIRE, AND RELATIONSHIP SATISFACTION BETWEEN MALE AND FEMALE PARTNERS DURING THE POSTPARTUM PERIOD AND THE IMPACT OF POSTPARTUM DEPRESSION

Abstract Introduction Studies suggest that changes in sexual health and relationship satisfaction are common in women during pregnancy and postpartum, however these are often overlooked during postpartum care. Furthermore, one in seven women experience additional challenges of postpartum depression within the first postnatal yea. Studies have recognized depression as a major predictor for reduced sexual desire and satisfaction. There is little empirical data on the impact of postpartum depression on the sexual health of both male and female partners and relationship satisfaction. Objective This study assesses the relationship between postpartum depression, relationship satisfaction, and sexual satisfaction at three postpartum time points: immediate, six weeks, and twelve weeks postpartum, in postpartum patients and their partners. Methods This longitudinal study was conducted on heterosexual couples recruited from the postpartum unit, excluding patients with pregnancy complications. Each partner was consented immediately postpartum and individually surveyed to evaluate their sexual desire, relationship satisfaction, and sexual dysfunction immediately, 6 weeks, and 12 weeks postpartum. The Sexual Desire Inventory-2, Sexual Dysfunction Questionnaire, and Couples Satisfaction Index were utilized. Mothers were additionally screened for postpartum depression using the Edinburgh Postnatal Depression Scale at the three time points. We then conducted a retrospective chart review from 6 and 12 week postpartum visits to investigate delivery details and sexual dysfunction screening as reported in clinic documentation. Results This sample consisted of 89 female (54.60%), and 74 male (45.40%). 5 had postpartum depression at least 1 timepoint (8.20%). Sexual desire differed significantly between female and male partners over the entire postpartum period (p &amp;lt; 0.01), and relationship satisfaction differed significantly over time throughout the postpartum period across both female and male partners (p &amp;lt; 0.01). Across the entire postpartum period, female partner sexual desire scores were, on average, 7.02 units lower than male partner sexual desire scores (Mean Difference; 95% CI: -7.02; -11.02, -3.02), meaning that female partner sexual desire was significantly lower than male partner sexual desire throughout the postpartum period. For both female and male partners, relationship satisfaction scores were significantly lower at 12 weeks postpartum (p &amp;lt; 0.01) and at 6 weeks postpartum (p &amp;lt; 0.01) as compared to immediately postpartum, meaning that both female and male partners were significantly less satisfied with their relationships at 6 weeks postpartum and at 12 weeks postpartum as compared to immediately postpartum. 82% females were not screened for sexual dysfunction at 6 weeks postpartum and 2% were screened. Conclusions Discrepancy in relationship satisfaction and sexual desire between male and female partners was found throughout the postpartum period. Yet, a majority of patients are not screened for sexual dysfunction at their 6 week postpartum visit. These findings elucidate the need to normalize and address sexual health during the postpartum period as standard of care, including screening and treatment, in both male and female partners. Disclosure No.

The role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function

BackgroundSexual function plays a very important role in the sexual health of people, and the determination of their related factors reflects the importance of paying attention to sexual function in the cultural context.ObjectiveThe present study aimed to the role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function.MethodsIn this descriptive-analytical cross-sectional study, 592 married women of reproductive age referring to comprehensive health centers in Rasht city (North of Iran) and eligible for the inclusion criteria were selected by cluster random sampling. The data collection tools were demographic information form, Halbert’s Sexual Rights Questionnaires, Women’s Sexual Self-Esteem (short form), Halbert’s Sexual Desire, and Female Sexual Function Index. Data analysis was done with descriptive and inferential statistical tests at a significant level (p < 0.05).ResultsThe mean and standard deviation of sexual assertiveness, sexual desire, and sexual self-esteem scores were 56.79 ± 18.24, 49.12 ± 26.04, and 98.52 ± 6.11, respectively. Sexual assertiveness (p < 0.01, r = 0.13), sexual desire (p < 0.001, r = 0.178), sexual self-esteem (p < 0.01, r = 0.34) of the participants with the total score, and all areas of female sexual function had a significant positive correlation.ConclusionBased on the findings, there is a direct and statistically significant relationship between sexual assertiveness, sexual desire, the adaptability of sexual self-esteem, and family income with sexual function in participants. However, the unemployment of the spouse had a negative effect on the female sexual function.

NRG-CC004 ancillary data study-exploring the effect of bupropion on sexual desire in female cancer survivors with and without vulvovaginal symptoms.

Female cancer survivors often experience estrogen-deprivation symptoms, which may lead to decreases in sexual desire, vulvovaginal health (lubrication, dryness, discomfort), and sexual satisfaction. Interventions are needed to address these concerns. The objective of this secondary analysis was to determine if women with higher (better) scores on the Female Sexual Function Index (FSFI) lubrication and pain subscales reported higher desire scores based on treatment with bupropion vs placebo. Participants were part of NRG Oncology's NRG-CC004 (NCT03180294), a randomized placebo-controlled clinical trial evaluating bupropion (150 vs 300mg) to improve sexual desire in survivors of breast or gynecologic cancer. All participants with baseline data from the FSFI lubrication, pain, and desire subscales with 5- and/or 9-week data were analyzed. The FSFI subscale scores were correlated using Spearman correlation coefficients. Logistic regression was used to determine associations between FSFI desire and other FSFI subscales while accounting for treatment arm and other covariates. The primary outcome of NRG Oncology's NRG-CC004 (NCT03180294) randomized phase II dose-finding trial was change from baseline to 9weeks on the FSFI desire subscale score. Similar to the parent study, the primary outcome for this ancillary data study was the FSFI desire subscale score at 5 and 9weeks. Overall, 230 participants completed the FSFI at baseline and 189 at 9weeks. The strongest correlations were between lubrication and pain at baseline (all participants, rho= 0.77; bupropion arms, rho = 0.82), week 5 (all participants, rho = 0.71; bupropion arms, rho = 0.68), and week 9 (all participants, rho = 0.75; bupropion arms, rho = 0.78), and the weakest correlations were between desire and pain. In patients in the treatment arms there were no interactions between lubrication or pain.The impact of various covariates on the FSFI score for desire at 9weeks demonstrated that participants of non-White race (odds ratio [OR],0.42; 95% CI, 0.21-0.81; P= .010), with a high lubrication score (OR,0.36; 95% CI, 0.21-0.61; P= .0002), with a high pain score (less pain) (OR,0.50; 95% CI, 0.29-0.87; P= .014), or with prior pelvic surgery (OR,0.38; 95% CI, 0.23-0.63; P= .0002) had lower odds of having low desire. Acute estrogen-deprivation symptoms should be addressed prior to sexual desire intervention. This secondary analysis was not powered to examine all variables. Lubrication and pain were predictors of low desire. Therefore, vulvovaginal atrophy and associated genitourinary symptoms of menopause such as vaginal dryness and dyspareunia should be addressed prior to or in parallel with interventions for sexual desire.

A mixture design approach to develop new starter formulation for Lben: Key aroma compounds, physical, chemical and sensory properties of the product

The study investigated the evolution of the physicochemical and sensory properties of Lben fermented milk inoculated with different starter formulations. The aim was to determine the optimal starter culture formula for Lben production using different combinations of four strains, including three strains of Lactococcus lactis subsp. lactis with strain codes A, E and F and one strain of Leuconostoc mesenteroides subsp. mesenteroides with strain code C. While individual strains had previously demonstrated significant technological and organoleptic properties their interaction in mixtures had not been explored. In the study, a response surface methodology (mixture design approach) was applied to evaluate the effects of the interactions between strains on the physicochemical, antioxidant, volatile, and sensory properties of Lben, a fermented milk. In addition, product optimization using ridge analysis was performed to determine the ideal strain mixture formulation based on the sensory properties of Lben. The optimization goal for odor, taste, consistency, and overall preference was set to maximize their values. A high desirability score of 0.832 was achieved with the following percentage distribution: 34.39% for L. lactis E, 42.38% for L. lactis A, 10% for L. lactis F, and 13.23% for Leuc. mesenteroides C.